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Year2 GI Exam I > Path III > Flashcards

Path III Flashcards

1
Q

esophageal varices are assoc with

A

portal HTN
alcoholics- cirrhosis
schistosomiasis mansoni or japonicum

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2
Q

presentation esophageal varices

A

asymptomatic then rupture and massive hematemesis

>30% fatality

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3
Q

what do esophageal varices look like on endoscopy

A

varices polypoid grape-like with cherry red spots

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4
Q

lye strictures

A

esophagitis

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5
Q

what infectious agents can cause esophagitis

A

candidiadis
herpesviruses
bacterial is uncommon

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6
Q

what is reflux esoophagitis

A

GERD

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7
Q

what does herpes esophagitis look like

A

punched out leasions, ulcers

intranuclear inclusions

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8
Q

clinical features GERD

A

> 40 y.o M>F obese>non-obese
mild and transient
heartburn, regurg, dysphagia
cough, chest pain

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9
Q

complications of GERD

A

esophageal ulceration
Barrett mucosa
stricture with stenosis
long-term risk of adenoca

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10
Q

most common cause gERD

A

loos tone of LES

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11
Q

histo of GERD

A

esosinophilia within squamous epithelium

elongation propria papillae and basal zone hyperplasia

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12
Q

What is NERD

A

non-erosive reflux disease,
no evidence of erosion
do not respond to PPIs

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13
Q

eosiniphilic esophagitis

A

failure high does PPI Tx in absence of acid reflux

atopic individuals

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14
Q

most important ADCA risk factor

A

barret esophagus, 30-40x increase if >3cm long

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15
Q

what reduces incidence ADCA in barrets esophagus

A

statins

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16
Q

what is a good stain for barrets esophagus

A

alcian blue stains the goblet cells

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17
Q

what are the benign tumors of esophagus

A 
mesenchymal
squamous papillomas (HPV related)
inflammatory "pseudotumor"
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18
Q

malignant tumors of esophagus

A

adenocarcinoma, SCC

leiomyosarcoma and GI stromal tumor are less common

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19
Q

distribution of ADCA of esophagus

A

7M:1F

white>hispanic

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20
Q

prognosis of ADCA esophagus

A

<25% 5 yr survival from time of Dx

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21
Q

common place ADCA esophagus

A

distal third of esophagus

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22
Q

signs of ADCA esophagus

A

pain, dysphagia, progressive weight loss, hematemesis, chest pain, vomiting

23
Q

histo ADCA esophagus? what stain?

A

holes with mucin in middle sometimes

mucicarmine stain

24
Q

90% malignant esophageal tumors are what

A

SCC

25
Q

risk factors SCC esophagus

A 
heavy smoking and ethanol intake
>50 y.o
diet, achlasia, HPV, plummer vinson
M4:1F
blacks 8:1caucasians
fermented milk- kenya
26
Q

prognosis SCC esophagus

A

5 yr survival is <10%

27
Q

most common place SCC esophagus

A

mid-esophagus

strictures, dysphagia, odynophagia, obstruction

28
Q

what does histo SCC esophagus look like

A

keratin pearls

no mucin

29
Q

what are the parts of stomach and cells in each area

superior to inferior

A 
cardia- mucous cells
fundus- parietal cells, chief cells
body
antrum- mucous cells, G cells
pylorus
30
Q

enterochromafin like cells in stomach secrete what

A

histamine

31
Q

G cells secrete?

D cells secrete?

A

G cells- gastrin

D cells- somatostatin

32
Q

chief cells secrete

A

pepsinogen and gastric lipase

33
Q

functions of gastrin

A

stimulate parietal cells and chief cells
contract LES
increase stomach motility
relax pyloric sphincter

34
Q

describe mucosa of stomach

A

superficial has specialized columnar cells

deeper has gastric puts with chief and parietal cells

35
Q

where are blood vessels, lymph and nerves in stomach

A

submucosa

36
Q

describe muscularis of stomach

A

outer zone for peristalsis: has outer longitudinal layer and internal circular layer
3rd layer of smooth muscle that is internal and oblique to the other layers

37
Q

describe serosa of stomach

A

thin zone CT

single layer mesothelial cells

38
Q

what is acute gastritis

A

acute mucosal inflammatory process of transient nature, Neutrophils present with or without ulceration

39
Q

acute hemorrhagic gastritis is assoc with what

A

NSAIDs like aspirin
heavy alcohol intake
heavy smoking
stress

40
Q

Tx stress gastric ulcers

A

PPIs

41
Q

stress ulcers are common in what patients

A

shock, burns, sepsis, severe trauma

critically ill

42
Q

what is gastropathy

A

repair process assoc with chronic episodes of acute gastritis
usually chemically induced

43
Q

how do Dx gastropathy

A

clinical

no signs.. sometimes pain vomtiing, maybe blood

44
Q

what cells are numerous in histo of acute gastritis

A

PMNs

45
Q

what do stress uclers look like on gross structure

A

black because there is digested blood (Hb) on surface

46
Q

what is chronic gastritis

A

presence of chronic mucosal inflammatory changes leading to atrophy and metaplasia usually in absence of erosions

47
Q

chronic gastritis is usually secondary to what

A

H pylori

48
Q

autoimmune gastritis is at increased risk for what

A

gastric cancer

49
Q

transmission H pylor

A

oral-fecal route

50
Q

gastritis assoc with H pylor attacks what part of stomach and patients at increase risk for what?

A

antrum

increased risk duodenal ulcer

51
Q

4 features H pylor virulence

A

flagella
urease- generates ammonia to elevate gastric pH
adhesins
toxins like cytotoxin assoc gene A

52
Q

What is hallmark of ongoign ifnection with H pylor

A

PMNs

53
Q

what does chronic inflammation from H pylori look like on histo

A

diffuse lymphocytic infiltrate and plasma cells in lamina propria
presence of lymphoid follicles= severe

54
Q

test for H pylor

A

swallow urea tagged with carbon 14 and then to breath test for C14
+ means H pylori present

Year2 GI Exam I (18 decks)

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